RU2308303C1 - Method for treating acute and chronic maxillary and frontal sinusitis cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves washing sinuses with Furacilin solution through artificially created fistula after having catheterized maxillary and frontal sinuses via puncture opening. The sinus cavities are filled with 0.5% Dihydroquercitin solution. Distal helium-neon laser end is introduced into the solution through catheter, and photophoresis is carried out at wavelength of 0.63 mcm, maximum output power of 50 mW, radiation flow intensity of 35-80 mW/cm², light spot diameter from 3 to 5 cm, single radiation dose of 3.5-6.2 J/cm². Exposure time is 5 min. Treatment course is 5 session long.

EFFECT: enhanced effectiveness of anti-oxidative tissue protection.

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Description

The invention relates to medicine, namely to a physiotherapeutic method for the treatment of acute and chronic sinusitis and frontal sinusitis in combination with dihydroquercetin in otorhinolaryngology.

Known methods of intracavitary low-energy irradiation of the sinus with a helium-neon laser (GNL) [1].

Intracavitary laser physiotherapy was performed after washing the paranasal sinuses using a monofilament fiber, the distal end of which was inserted into the sinus (maxillary or frontal) through a catheter, as well as into the nasal cavity and nasopharynx. Laser physiotherapy was carried out using commercially available GNL LG-38 with a wavelength of 0.633 μm and an energy exposure of 10 J / cm. The course of treatment ranged from 2 to 9 sessions (an average of 5).

The disadvantages of the method are:

1. The effect of an intracavitary helium-neon laser is not effective enough without its simultaneous use with antibiotics, sulfonamides, antioxidants, desensitizing and other means.

2. With laser physiotherapy, a later normalization of blood biochemical parameters in patients with chronic sinusitis was noted as a criterion for effective treatment.

As a prototype taken phonophoresis method according to the external method of using the antioxidant dibunol on the projection area of the paranasal sinuses.

An external technique was used with preliminary introduction of an average nasal passage of 5% of the dibunol liniment on turunda and 10% on the emitter, as well as on the skin in the nose and projection of the frontal and maxillary sinuses. The duration of the physiotherapeutic effect is 15 minutes. The course of treatment is 10-15 days, which led to an increase in the reserve capabilities of antioxidant protection under conditions of free radical oxidation activation [2].

The disadvantages of the prototype are:

1. The lack of effectiveness of the external phonophoresis method lies in the fact that the penetration of drug ions into the paranasal cavities is blocked by a powerful bone barrier in the form of the front walls of the paranasal sinuses, which significantly reduces the physiotherapeutic effect of this method.

2. The membrane protective effect of the antioxidant is to inhibit lipid peroxidation, and the increase in antioxidant protection is significantly reduced due to its local application and the slow accumulation of sufficient antioxidant concentration in the patient’s blood for a physiotherapeutic effect.

The aim of this invention is to enhance the action of dihydroquercetin with an antioxidant effect and its penetration into the mucous membrane of the frontal and maxillary sinuses under the influence of the LA-1 helium-neon laser with a light spot diameter of 3 to 5 cm.

This goal is solved by the fact that after catheterization of the frontal and maxillary sinus through a puncture hole or artificially imposed anastomosis after surgery, the cavity of the frontal and maxillary sinus was washed with furatsillin solution and then the sinus cavity was filled with 0.5% dihydroquercetin solution (antioxidant), followed by introduction into the solution a distal optical fiber end HeNe laser "LA-1" with a wavelength of 0.63 microns, a maximum output of 50 mW output power, power flux density of 35-80 mW / cm ^2, diameter Vetovo stains from 3 to 5 cm, a single dose of radiation of from 3.5 to 6.2 J / cm. The duration of photophoresis, in which a 0.5% solution of dihydroquercetin was illuminated in the sinus cavity and its mucous membrane, was 5 minutes. The course of treatment was 5 sessions.

Concrete example

Under observation was 21 patients aged 18 to 57 years with various forms of acute and chronic frontal sinusitis and sinusitis.

Example. Patient S., 24 years old, was hospitalized in the ENT department of AOKB with a diagnosis of Chronic bilateral sinusitis, purulent form. After the examination, the patient underwent puncture of both the maxillary sinuses with the introduction of a catheter into the sinus cavity, through which the sinus was washed with furatsillin solution. In the patient’s position, lying on the side of the punctured sinus, a 0.5% solution of dihydroquercetin with an antioxidant effect was injected into the sinus cavity through the catheter until it was completely filled, then the distal end of the LA-1 helium-neon laser was inserted through the catheter into the sinus cavity with a wavelength of 0.63 μm, a maximum output radiation power of 50 mW, a light spot diameter of 3 to 5 cm, a power flux density of 35-80 mW / cm ² , a single dose of radiation ranged from 3.5 to 6.2 J / cm. Laser radiation affected the solution located in the sinus cavity and its mucous membrane; the exposure time was 5 minutes. The duration of the photophoresis technique with a 0.5% dihydroquercetin solution was 5 minutes.

Simultaneously with photophoresis, a study of blood biochemical parameters was carried out to assess the effectiveness of the treatment in comparison with patients who underwent laser helium-neon irradiation of the paranasal sinus cavity (Table 1).

The dynamics of lipid peroxidation after treatment (table 1).

Table 1. Indicators in nmol / l Indicators before treatment in nmol / l GNL GNL + dihydroquercetin Lipid hydroperoxides (normal - 28.5 ± 0.6) 33.51 ± 0.29 29.71 ± 0.28 28.65 ± 0.31 Diene conjugates (norm - 29.98 ± 0.61) 32.41 ± 0.32 30.75 ± 0.30 30.09 ± 0.28 Malondialdehyde (normal - 5.79 ± 0.12) 7.19 ± 0.27 6.51 ± 0.25 5.95 ± 0.28

A solution of dihydroquercetin introduced into the maxillary sinus cavity and helium-neon laser radiation contributed to the rapid accumulation of the required concentration of antioxidant in the sinus mucosa, which contributed to the inhibition of lipid peroxidation and increased the level of tissue antioxidant protection (Table 2).

The dynamics of antioxidant defense after treatment (table 2).

Table 2. The indicators in mcg / ml Indicators before treatment in
mcg / ml GNL GNL + dihydroquercetin Tocopherol acetate (normal - 22.05 ± 0.55) 19.45 ± 0.23 21.28 ± 0.21 21.90 ± 0.21 Ceruloplasmin (normal - 22.0 ± 0.37) 20.12 ± 0.25 21.05 ± 0.23 21.87 ± 0.22

Information sources

1. Pluzhnikov MS, Lopotko A.I. Low-energy laser radiation in rhinology // Russian rhinology. - 1995. - No. 3-4. - p. 42-47.

2. Skvirskaya I.V. The effectiveness of the use of antioxidants in the treatment of patients with polypous sinusitis. Abstract. Cand. honey. sciences. - Kiev. 1992. - 18 p.

Claims (1)

A method for treating acute or chronic sinusitis and / or frontal sinusitis, characterized in that after catheterization of the maxillary and / or frontal sinus, the sinus cavities are washed with furacilin solution through a puncture hole or artificially imposed anastomosis, then the sinus cavities are filled with 0.5% dihydroquercytin solution, a distal end of the helium-neon laser fiber is introduced into the solution through a catheter and photophoresis is performed with a wavelength of 0.63 μm, a maximum output radiation power of 50 mW, and a power flux density of 3 5-80 mW / cm ² , the diameter of the light spot from 3 to 5 cm, a single dose of radiation from 3.5 to 6.2 J / cm ² , the exposure duration of 5 minutes, the treatment course of 5 sessions.